Title: Impact of SB 273 on West Virginia Patients, Providers, and Overall Prescription Rates of Opiate Medications Abstract: Opiate use disorders are the cause of unprecedented morbidity and mortality in the United States and West Virginia over the past decade. On March 27, 2018, new opiate prescribing limits (SB 273) were signed, and implemented several months later across the State of West Virginia in an effort to combat the opiate misuse epidemic. There is a critical need to understand the role of SB 273 upon prescribing habits and the availability of opiates within the state. While external drivers may be key factors for de-implementation for low- yield/high-risk practices such as the widespread use of opiates, it is essential to systematically understand the effect of such external drivers and policy changes. The purpose of this study is to utilize quantitative and qualitative measures to determine the effect of the recent opiate prescription laws in West Virginia. The goal of this application is to discern the effect of state opiate prescribing policy changes on prescribing practices. This application fits into the de-adoption framework proposed by Niven and colleagues with the goal to ?Evaluate de-adoption process and outcomes.? Furthermore, this application offers the opportunity to systematically study how a change in policy affects the opiate misuse epidemic and apply this knowledge more broadly. The research team will 1) collaborate with the West Virginia Board of Pharmacy to ascertain changes in opiate prescribing habits before and after the start of SB 273 using an interrupted time series methodology, and 2) achieve broad and deep understanding of how SB 273 has affected prescribing practices and experiences amongst the following stakeholders: primary care physicians, specialists (pan physicians, surgeons, emergency room physicians, etc), and patients who currently or previously utilized opiate medications.